ABSTRACT
Adverse drug reactions to highly antiretroviral therapy (HAART) are major obstacles in its success. Although overall mortality from HIV has dramatically declined owing to HAART, these antiretroviral regimens have been associated with a wide spectrum of severe cutaneous reactions. The severity of cutaneous adverse reactions varies greatly, and some may be difficult to manage. To optimize adherence and efficacy of antiretroviral treatment, clinicians must focus on preventing adverse effects whenever possible, and distinguish those that are self-limited from those that are potentially serious. This paper presents the case of a serious cutaneous adverse reaction to Atripla in a HIV-positive 50-year-old Caucasian woman.
ABSTRACT
BACKGROUND: Interventions that may reduce the number and severity of potentially harmful post-stroke complications are desirable. This study explored whether very early and frequent mobilisation (VEM) affected complication type (immobility/stroke related), number and severity. METHODS: Secondary analysis from phase II, randomised controlled trial. Patients admitted within 24 h of stroke, whose physiological parameters fell within set limits, were randomised to either VEM, commencing <24 h, or standard care. Complications to 3 months were recorded by a blinded assessor and classified by a neurologist. Analysis was intention to treat. RESULTS: Seventy-one patients were recruited (standard care 33; VEM 38).There were no significant group differences in the number, type or severity of complications by 3 months, and most patients (81.6%) experienced one or more complications. Falls were common, while depression was absent. The multivariate analysis showed older age (OR 1.10, 95% CI: 1.02-1.18, p = 0.009) and longer length of stay (OR 1.18, 95% CI: 1.06-1.32, p = 0.002) were associated with experiencing an immobility-related complication. CONCLUSION: Interventions that promote recovery and reduce complications may consequently reduce length of stay. The larger phase III trial currently underway may shed light on whether increasing mobilisation reduces complications after stroke.
Subject(s)
Bed Rest/adverse effects , Early Ambulation , Stroke Rehabilitation , Accidental Falls/prevention & control , Age Factors , Aged , Aged, 80 and over , Depression/etiology , Depression/prevention & control , Female , Humans , Length of Stay , Logistic Models , Male , Middle Aged , Odds Ratio , Recurrence , Risk Assessment , Risk Factors , Severity of Illness Index , Single-Blind Method , Smoking/adverse effects , Stroke/complications , Stroke/mortality , Stroke/psychology , Time Factors , Treatment Outcome , Urinary Tract Infections/etiology , Urinary Tract Infections/prevention & control , Victoria/epidemiologyABSTRACT
The measurement technologies currently available to quantitatively evaluate neurological tremors have several limitations. For this reason the assessment of disorders involving tremor is largely based on subjective clinical evaluation of the patient. The availability of a high-sensitivity, portable and easy to use instrument based on force plate technology, coupled with a customized data analysis protocol could represent a useful tool for the clinician. To verify such a hypothesis, baseline physiological tremor information in a standing posture was collected from normal subjects. A lightweight portable force plate was built and used in collecting vertical ground reaction force data, which was subsequently analyzed for frequency content and power spectral distribution. Repeatability of results in a group of subjects without any diagnosed neurological disorders, and intra-subject repeatability, as well as influence of footwear were investigated.
